b"and hyperextension, and can be combined2. For bilateral weakness or signicant loss of with an AFO to control both knee and ankle. balancetwo canes, walking sticks, crutches, Recent arrivals to bracing options are devicesor a walker is better than one cane. to help swing a weak leg forward, including a3. Four-wheeled walkers must have brakes Becker hip-exion assist device and a triple- that work and hands kept near the brakes ex brace. Most insurances will pay for at leastwhen in use.50 percent of the cost of AFOs and other4. Pick-up walkers and two-wheeled walkers orthoses, and organizations such as MS Focus:dont need brakes, which is good for people the Multiple Sclerosis Foundation have grantwith upper limb weakness or slow reactions.programs to help with the expenses that are5. Most falls happen in the home, so a walker not covered. When a brace is brand new, startis just as important in the home as outside. with an hour or two of daily wear, and then gradually increase wear-time. Bring your orthoses,Medicationsto medical and rehabilitation appointments,What about medications that can help with so the provider can see what you are using andwalking in MS? First, there is evidence that how well it is working for you. disease-modifying drugs can prevent disability Electrical stimulation and deserve credit for the fact that people Electrical neuro-stimulators are wearablewith MS are more likely to stay ambulatory products that stimulate calf and shin muscles today than at any other time in history. Your MS to signal gait motions to occur at the right phasehealthcare team will help to determine what of the walking cycle. They dont require specialmedication regimen is right for you. A drug footwear, but the shock can be uncomfortablethat does not affect the immune system but and may not always create enough musclestill has a role in MS mobility is dalfampridine contraction to move the joint properly. They are(genericforAmpyra).Dalfampridineisa also more expensive than nonelectrical optionspotassium channel blocking oral drug that can improve conduction in the central nervous and usually are not covered by insurance.system of some people with MS. It helps about Nonetheless, neuro-stimulators that augmentone-third of those with gait problems walk movementareanexcitingandrapidlyfaster. Those with kidney disease or seizures advancing eld with promise to help peoplecannot take the medication. Spasticity with MS. medications can treat those with a stiff, spastic Rules for devices gait.Assistive devices for walking include canes,Exercisewalkingsticks,forearmcrutches,walkers,Saving the best for last, exercise is still the andotherplatforms,suchastheA-linkerbest way to sustain and improve walking ability bike. Device selection, proper use, and safetyin MS. Target your areas of difficulty, work on are important. So, it's good advice to workbalance or specic muscle strengthening, or, with a physical therapist to determine whatbetter yet, combinations of different types of kind of assistive device is needed and how toexercise. Ask for a physical therapy referral if use it. Here are some quick rules for devices:you need help getting started with an exercise 1. A cane should go in the hand opposite theprogram that is right for you. And remember, weaker leg and be swung in tandem withwalking for exercise is a self-fullling activity. the weaker leg. The more you walk, the better you will walk.7 msfocusmagazine.org"